Chlordiazepoxide in depressive neurosis: an open label cross-over study with amitriptyline

Sixty-five depressed outpatients were treated in an open label cross-over study of chlordiazepoxide and amitriptyline. The treatment was changed only in those patients in whom the response to the first medication was inadequate. Global rating and self-rating scales were compounded into a rating of treatment preference. For the group as a whole chlordiazepoxide appeared to be more effective than amitriptyline. The patients who responded to treatment with chlordiazepoxide tended to show reactivity, symptoms of anxiety or tension and were not retarded. Chlordiazepoxide appeared to be more effective in patients who were initially diagnosed as suffering from exogenous depressions, whereas amitriptyline appeared to be more effective in those with endogenous depressions. The findings suggest that in a large proportion of depressed patients it is possible to predict from their clinical features which class of psychotropic drugs is likely to be more effective.